EYE MOVEMENT DESENSITISATION AND REPROCESSING
Eye Movement Desensitisation and Reprocessing (EMDR) was created by DR Francine Shapiro, a Psychologist and Senior Research Fellow at the Mental Research Institute in Palo Alto, USA. It is an innovative clinical treatment, which has successfully helped over one million people who have experienced psychological difficulties which originate from some kind of traumatic experience, such as sexual abuse, childhood neglect, road traffic accidents and violence. EMDR is also successful in treating other complaints such as performance anxiety, self-esteem issues, phobias, and other trauma related anxiety disorders. EMDR is a complex method of psychotherapy which integrates many of the successful elements of a range of therapeutic approaches, and combines them with eye movements or other forms of bilateral stimulation in ways which stimulate the brain's information processing system.
Normally, the individual processes traumatic experiences naturally. However, when a person is severely traumatized, either by an overwhelming event or by being repeatedly subjected to distress, this healing process may become overloaded, leaving the original disturbing experiences unprocessed. These unprocessed memories can be stored in the brain in a "raw" form where they can be continually re-evoked when experiencing events that are similar to the original experience.
EMDR utilizes the body's natural healing ability and allows the brain to heal psychological problems at the same rate as the rest of the body heals physical ailments. Because EMDR allows the mind and body to heal at the same rate, treatment can be rapid. The number of sessions required for EMDR treatment, however, will vary according to the complexity of the issues being dealt with. In general, the more isolated the traumatic memory being treated, the shorter the treatment tends to be.
There have been many controlled studies supporting the efficacy of EMDR, making it the most thoroughly researched method in the treatment of trauma. The most recent five studies with people suffering from a range of events such as rape, combat, bereavement, accidents, natural disasters etc. have found that 84 - 90% of the participants no longer had Post-traumatic Stress Disorder following EMDR treatment. Given its wide application, EMDR promises to be the therapy of the future.
The EMDR practitioners training consists of three parts: a basic, an intermediate and an advanced level. Only individuals who have completed all three levels of training are sufficiently trained to conduct EMDR therapy.
This form of therapy is based on the principle that the way people think, feel and behave results from learning processes, therefore, it follows that people can unlearn and relearn different ways of coping. It suggests that thoughts, feelings and behaviour(s) are interlinked and that if any aspect of these areas is unhelpful it can affect the others.
For example: If a person thinks that something bad is going to happen to them in a given situation it is likely that they will experience unhelpful emotions such as, anxiety. In turn these emotions can reinforce the way the person thinks and this may lead to avoidance of the situation. If avoidance occurs this is likely to reinforce the fears (thoughts) and then even thinking about the situation can lead to the person experiencing unhelpful emotions.
If a person does not think well of themselves and always sees the negative side of things, they are likely to experience emotions such as, depression, and this can lead to changes in the way they behave. Typical changes associated with this type of problem are withdrawal from others and reduction in activities. Once again these behavioural changes can lead to reinforcement of negative thoughts and feelings.
CBP helps people to identify and modify unhelpful ways of thinking and behaving, which will ultimately affect the way they feel. It also helps people to learn more effective ways of coping, which will, hopefully, help them maintain symptom relief and prevent relapse in the future. It focuses on ‘here and now’ experiences, although it usually includes identifying how past experiences have influenced the development of the present day problems.
An agenda is set for each session to ensure that all of the important issues are covered and that enough time is spent on them to work on them effectively. Initially, the therapist sets the agenda but as time progresses it is helpful for you to also take part in this.
You will often be expected to take an active part in therapy and carry out work in between sessions. This is because the main aim is to teach you skills and techniques, which you can implement to help you overcome your problems.
MINDFULNESS BASED COGNITIVE BEAHVIOURAL THERAPY
In brief, MCBT is based on the idea that in order to recognise and modify unhelpful thoughts, we have to understand and have some control over the processes in our Mind which produce them; “we cannot change a problem with the means that created it” (Einstein). Mindfulness and acceptance-based approaches take the view that attempting to change the content of incapacitating thoughts is less productive in the long term than learning to develop control over the processes that maintain them.While Mindfulness is rooted in many spiritual disciplines, notably Buddhism, the Mindfulness Practice can be effectively learned and applied in its own right without involvement in any religion.
In CBT we are encouraging clients and patients to become aware of their thoughts, to concentrate on their thinking patterns so that they can begin to learn how to take control of the unhelpful thoughts and eventually introduce more helpful thoughts into their minds. But how can this happen if the mind is continually distracted? How can the monkey settle on one particular piece of fruit if he is being continually seduced away by other more juicy fruits?
Mindfulness Practice proposes that we can take control over how our own Mind works by actually practising looking at our thoughts with growing interest and acceptance; understanding how our Mind works, how thoughts are created from each other, the predominance of certain thought trends or foci.
Ultimately, after a regular practice, perhaps 20 minutes a day for a few months, it becomes possible to create more and more of a ‘choice’ about whether we want to follow a particular thought pattern or thought emphasis. We learn to observe what is actually happening in our Mind, to accept in a spirit of kindness towards ourselves that this is what is happening, this is the actual state of our Mind, then begin to work positively with our distractions as we gain more and more choice and control over what happens in our minds.
Cognitive reappraisal emerges naturally from this freeing experience. "Self-worth", or rather satisfaction with life, springs from a deep sense of achievement, sense of self-control and self-efficacy.
For someone working in CBT, practicing Mindfulness will help them know their Mind and how their unhelpful thoughts are actually being created. They will not only be able to change the unhelpful thoughts, but also change the very process that produces the thoughts in the first place. This is like a doctor who looks at the someone ‘s whole way of life in order to understand the root of why their knee is sore; rather than just treating the sore knee in isolation.
Psychodynamic therapy is a general name for therapeutic approaches which try to get the patient to bring to the surface their true feelings, so that they can experience them and understand them. Like Psychoanalysis, Psychodynamic Psychotherapy uses the basic assumption that everyone has an unconscious mind (this is sometimes called the subconscious), and that feelings held in the unconscious mind are often too painful to be faced. Thus we come up with defences to protect us knowing about these painful feelings. An example of one of these defences is called denial, which you may have already come across.
Psychodynamic therapy assumes that these defences have gone wrong and are causing more harm than good, that is why you have needed to seek help. It tries to unravel them, as once again, it is assumed that once you are aware of what is really going on in your mind the feelings will not be as painful.
Psychodynamics takes the approach that our pasts effects our presents. Those who forget history are doomed to repeat it, and this is the same for an individual. Though we may repress our very early experiences (thus we don't remember them) the theory is that the "ID" never forgets the experiences. If a child was always rewarded with sweets we may not know why we reach for the tub of ice cream whenever we are depressed and we want cheering up.
If we go back to our own beginnings, we will see that all of us develop ways of relating to others based on experiences with those who cared for us in our formative years. Freud realised feelings previously felt in connection with parents or significant others were being transferred from the past into the present: the transference. Why should this he so? Before I attempt to answer this question it is important to point out that all our relationships have an element of transference in them: into each new meeting both participants bring expectations and assumptions based on previous encounters.
However, in most situations, particularly social ones, there is inter-action: exchange of opinion, agreement, argument, attraction, flirtation, aggression, repulsion, and so on. In this way, through interaction, our expectations and assumptions are either confirmed, contradicted or modified.
Some of our understanding will come through the feelings the therapist has about the clients, the emotions that are stirred up in the therapist in their affiliation with them: the countertransference. People all know that different people evoke different feelings, and most of us tend to avoid those who stir up unpleasant emotions, and seek the company of those who make us feel good.
The person-centred approach maintains that three core conditions provide a climate conducive to growth and therapeutic change. They contrast starkly with those conditions believed to be responsible for psychological disturbance. The core conditions are:
Unconditional positive regard
The first — unconditional positive regard — means that the counsellor accepts the client unconditionally and non-judgementally. The client is free to explore all thoughts and feelings, positive or negative, without danger of rejection or condemnation. Crucially, the client is free to explore and to express without having to do anything in particular or meet any particular standards of behaviour to ‘earn’ positive regard from the counsellor.
The second — empathic understanding — means that the counsellor accurately understands the client’s thoughts, feelings, and meanings from the client’s own perspective. When the counsellor perceives what the world is like from the client’s point of view, it demonstrates not only that that view has value, but also that the client is being accepted.
The third — congruence — means that the counsellor is authentic and genuine. The counsellor does not present an aloof professional facade, but is present and transparent to the client. There is no air of authority or hidden knowledge, and the client does not have to speculate about what the counsellor is ‘really like’.
Together, these three core conditions are believed to enable the client to develop and grow in their own way — to strengthen and expand their own identity and to become the person that they ‘really’ are independently of the pressures of others to act or think in particular ways.
As a result, person-centred theory takes these core conditions as both necessary and sufficient for therapeutic movement to occur — i.e., that if these core conditions are provided, then the client will experience therapeutic change. (Indeed, the achievement of identifying and articulating these core conditions and launching a significant programme of scientific research to test hypotheses about them was one of the greatest contributions of Carl Rogers, the American psychologist who first began formulating the person-centred approach in the 1930s and 1940s.)
Notably, person-centred theory suggests that there is nothing essentially unique about the counselling relationship and that in fact healthy relationships with significant others may well manifest the core conditions and thus be therapeutic, although normally in a transitory sort of way, rather than consistently and continually.
Finally, as noted at the outset, the person-centred approach takes clients as their own best authorities. The focus of person-centred therapy is always on the client’s own feelings and thoughts, not on those of the therapist — and certainly not on diagnosis or categorization. The person-centred therapist makes every attempt to foster an environment in which clients can encounter themselves and become more intimate with their own thoughts, feelings and meanings.
Ethics & Codes of Conduct
We adhere to several codes of conduct to ensure we provide an ethical service that provides protection for the client, both in terms of standards and accountability.
HEALTH PROFESSIONS COUNCIL
Standards of conduct performance & ethics
BRITISH ASSOCIATION FOR BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPIES
Standards of Conduct, Performance and Ethics in the Practice of Behavioural and Cognitive Psychotherapies
BRITISH ASSOCIATION FOR COUNSELLING AND PSYCHOTHERAPY Ethical Framework for Good Practice in Counselling and Psychotherapy
The British Psychological Society Code of Ethics and Conduct